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Coma

Causes
Clinical features
Investigations
Immediate management
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Immediate management

Assess the level of consciousness using the Glasgow Coma Scale. a

Glasgow Coma Scale (GCS): Minimum score: 3   Maximum score: 15

Response Score
Eye opening
 - spontaneous 4
 - on verbal command 3
 -  to pain 2
 - no response 1
Motor response
 - correct response to ‘show me 2 fingers’ 6
- localises pain and tries to stop it 5
- withdraws from painful stimuli to fingernail 4
- abnormal flexor response of forearms, wrists and fingers 3
- abnormal extensor response of arms and legs 2
-  no response 1
Verbal response to question ‘what year is this?’
- correct year 5
- wrong year 4
- words but no year 3
-   incomprehensible sounds 2
- no response 1

Why?

  • Clinic staff agree better using GCS than using simple descriptions. a
  • It helps predict mortality a b

Expiry date: September 2003
Levels of Evidence used in grading these guides

Authors   W   Whiteley , CM   Ball
Reviewer   M   Daniel
CAT Writers   W   Whiteley , CM   Ball